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Bites and Stings

Michigan Snakes

About 45,000 people are bitten by snakes every year in the United States. Of those, 7,000 involve poisonous snakes, and of those treated, only about 15 die. More than half of the poisonous snakebites involve children, and most occur between April and October. Of the poisonous bites in the United States, 55 percent are from rattlesnakes, 34 percent from copperheads, 10 percent from water moccasins, and one percent from coral snakes. Rattlesnake bites account for 70 percent of the fatalities and between 95 and 98 percent of the bites occur on extremities.

Symptoms generally occur immediately, but only about one third of all bites manifest symptoms. When no symptoms occur, probably no venom was injected into the victim. Poisonous snakebite venom contains some of the most complex toxins known; venoms can affect the central nervous system, brain, heart, kidneys, and blood.

Signs that indicate a poisonous snakebite include:

The bite consists of one or two distinct puncture wounds. Nonpoisonous snakes usually leave a series of small, shallow puncture wounds because they have teeth instead of fangs. The exception is the coral snake, which leaves a semicircular marking from its teeth. Because some poisonous snakes also have teeth, fang and teeth marks may be apparent. The presence of teeth marks does not rule out a poisonous bite, but the presence of fang marks always confirms a poisonous snakebite.

Large fangs; nonpoisonous snakes have small teeth.

The two fangs of a poisonous snake are hollow and work like a hypodermic needle.

The rattlesnake often shakes its rattles as a warning. BUT NOT ALWAYS!

One snake that is not a pit viper snake but is poisonous is the coral snake. The coral snake is highly poisonous and resembles a number of nonpoisonous snakes. Coral snakes, as proteroglyphous elapids, have fixed fangs as opposed to retractable fangs. Because its mouth is so small and its teeth are short, most coral snakes inflict bites on the toes and fingers. They have to chew the skin a while to inject venom. Coral snakes are small and ringed with red, yellow, and black. The chances for recovery of a snakebite are great if the patient receives care within two hours of the bite.

You can decide how serious the bite is by considering several factors:

The age, size and general health of the patient. A small child will probably react much more severely to a smaller amount of venom than will an adult. Bites are most dangerous in children and the elderly.

The depth, location and number of bites. A single, glancing blow by the fangs is much less dangerous than multiple wounds or wounds that penetrate the flesh deeply. A bite that penetrates a blood vessel is extremely dangerous. The least dangerous bites occur on the extremities and in fatty tissue. Bites on the head or trunk are usually fatal.

The duration of the bite. The longer the bite, the greater the amount of venom that may be injected into the patient’s system.

Clothing. A snake that bites through several layers of clothing will not leave as much venom as a snake that strikes bare skin.

Maturity, type, and size of the snake. Small snakes usually do not produce enough venom to seriously harm an adult.Condition of the fangs and venom sacs. More venom will be injected if the fangs and venom sacs are in good condition.

How angry or fearful a snake is. More venom will be injected if the snake is angry or fearful.Treatment for snakebite:

The priorities of emergency care for snakebite are to maintain basic life support – airway, breathing and circulation – and limit the spread of the venom and to transport the patient without delay.

Move the patient away from the snake to prevent repeated bites or bites to yourself. Snakes cannot sustain prolonged rapid movement so are often within a 20 foot radius of where the bite first occurred.

Have the patient lie down and keep them quiet. Reassure them to slow the metabolism and subsequent spread of the venom.

Cut and suck methods are useless. According to one study, the most you can get is six percent of the venom. Many people do far more damage when they cut than they do good.

Keep the bitten extremity at the level of the heart.

Remove any rings, bracelets or other jewelry that could impede circulation if swelling occurs.

Clean the wound gently with alcohol, soap and water, hydrogen peroxide or other mild antiseptic.

Do not cool or chill or apply ice.

Do not attempt to tie any type of tourniquet or constricting bands.

Transport the patient as soon as possible to the hospital. Signs and symptoms of a coral snake bite are different than those of a pit viper. Rather than leaving two distinct fang marks, the coral snake leaves one or more tiny scratch marks in the area of the bite. There is little pain or swelling and the patient’s tissue usually does not turn black and blue. Usually, there is no pain or swelling at the bite site. However, one to eight hours after the bite, the patient will experience blurred vision, drooping eyelids, slurred speech, increased salivation and sweating. Emergency care for a coral snake bite is similar to that for a pit viper snake bite.

Insect / Spider Bites

Insect bites and stings are common, and most are considered minor. It is only when the insect is poisonous or when the patient has an allergic reaction and runs the risk of developing anaphylactic shock that the situation becomes an emergency. Even under those conditions, accurate diagnosis and prompt treatment can save lives and prevent permanent tissue damage. The normal reaction to an insect sting is a sharp, stinging pain followed by an itchy, swollen, painful raised area. The swelling may be there for several days but usually goes away within 24 hours. Local reactions are rarely serious or life-threatening and can be treated with cold compresses.

However, there are some people who have allergic reactions to “normal” insect stings. Approximately 50 people die each year in the United States from insect stings. This is more than all other bites combined including snakebites. Thousands of people are allergic to bee, wasp, and hornet stings. Insect stings can be deadly for those people, on the average, within 10 minutes of the sting but almost always within the first hour.

The stinging insects that most commonly cause allergic reactions belong to a group of the hymenoptera, the insects with membranous wings. These include bees, wasps, hornets, and yellow jackets. Stings from wasps and bees are the most common.

Black Widow Spider
The black widow is a spider with a shiny black body, thin legs and an hourglass shaped red/white mark on its abdomen. The female is much larger than the male and is one of the largest spiders in the United States. Males generally do not bite. Females bite only when hungry, agitated or protecting the egg sac. The black widow is not aggressive. They are usually found in dry, secluded, dimly lit areas. More than 80 percent of all bite victims are adult men.

Black widow spider bites are the leading cause of death from spider bites in the United States. The venom is 14 times more toxic than rattlesnake venom. It is a neurotoxin that causes little local reaction but does cause pain and spasms in the larger muscle groups of the body within 30 minutes to three hours. Severe bites can cause respiratory failure, coma and death.

Those at the highest risk are children under age 16, the elderly, people with chronic illness and people with high blood pressure. Signs and symptoms of a black widow spider bite:

A pinprick sensation at the bite site, becoming a dull ache within 30 to 40 minutes

Pain and spasms in the shoulders, back, chest, and abdominal muscles within 30 minutes to three hours

Rigid, boardlike abdomen

Restlessness and anxiety

Fever

Rash

Headache

Vomiting and nausea

Flushing

Sweating

Grimacing

The symptoms usually last 24 to 48 hours. Treatment:

Treat for shock

Apply a cold compress but do not apply ice

Transport to hospital as quickly as possible

Brown Spiders
Brown spiders are often called violin spiders because of the characteristic “violin-shaped” marking on the upper back. They are generally brown but can range in color from yellow to dark brown.

The bite of the brown spider is a serious medical condition. The bite is non healing and causes tissue death. Sometimes surgery is necessary. The bite causes only a mild stinging sensation if any at all. Victims often are unaware they have been bitten. Several hours after the bite, the following signs and symptoms begin to result:

A small white area appears surrounded by a margin of redness which may produce a mild itching pain.

A blister appears surrounded by mild swelling and redness.

A “bulls-eye” or “target” lesion develops

There may be fever, chills, rash, hives, nausea and pain in the joints over the next few days.

The target lesion will enlarge over the next few days and produce extensive tissue death. There is no anti venom. The lesion will have to be soaked in antiseptic and possibly antibiotics. Surgery may be necessary to cut out the dead tissue.

Africanized Honey Bees
Africanized honey bees were imported to Brazil in 1956 to enhance honey production in the tropics. Some of the bees escaped into the wild and have gradually moved towards North America. Africanized honey bees are the temperamental cousin of the more common European honey bee. They often are called “killer bees”, but in reality their stings are less potent and painful than the common bee sting. Contrary to portrayal in the movies, these bees do not swoop down in mass causing death and destruction. They do defend their nesting sites very aggressively, sometimes stinging their victims hundreds of times.

It is impossible for the average person to tell the difference between an Africanized honey bee and the common European honey bee. Only an expert with sophisticated lab equipment is able to distinguish between the two. Those at highest risk are individuals who are allergic to bee stings and pets that are penned or tied up near honey bee hives.

Do’s and Don’ts

DO check your property regularly for bee colonies. Honey bees nest in a wide variety of places, especially Africanized honey bees. Check animal burrows, water meter boxes, overturned flower pots, trees and shrubs.DO keep pets and children indoors when using weed eaters, hedge clippers, tractor power mowers, chain saws, etc. Attacks frequently occur when a person is mowing the lawn or pruning shrubs and inadvertently strikes a bee’s nest.DO avoid excessive motion when near a colony. Bees are much more likely to respond to an object in motion than a stationary one.

DON’T pen, tie or tether animals near bee hives or nests.DON’T remove bees yourself. If you want bees removed, look in the yellow pages under “bee removal” or “beekeepers”.

What to do if you are attacked:

Run as quickly as you can away from the bees. Do not flail or swing your arms at them, as this may further annoy them.

Because bees target the head and eyes, cover your head as much as you can without slowing your escape.

Get to the shelter or closest house or car as quickly as possible. Don’t worry if a few bees become trapped in your home. If several bees follow you into your car, drive about a quarter of a mile and let the bees out of the car.

When to call the Fire Department:
Call the fire department only when emergency medical services are needed. If someone has been stung by many bees at once or has an allergic reaction to a bee sting, call 9-1-1. Call the fire department if someone has become trapped in a building or car with lots of bees. DO NOT call the fire department to remove bee colonies or hives. If you want bees removed, look in the yellow pages under “bee removal” or “beekeepers”.

How to treat stings from Africanized bees:
Treating stings from Africanized bees is much the same as treating a common bee sting. If a person is stung:

Keep the affected area below the heart

If the sting was by a bee and the stinger is still in the skin, remove it by gently scraping against it with your fingernail, a credit card or a knife. Be careful not to squeeze the stinger. The venom sac still will be attached and you will inject additional venom into the area. Be sure to remove the venom sac.

Apply cold compresses to relieve pain and swelling but do not apply ice directly.

If it becomes difficult to breathe, call 9-1-1. Itching should quit within a few hours. If it persists beyond two days, or if signs and symptoms of an allergic reaction occur after an insect bite you should be seen by a doctor. The signs and symptoms of an allergic reaction include: